Provider First Line Business Practice Location Address:
3630 S GEYER RD
Provider Second Line Business Practice Location Address:
DEPT ORTHOPAEDIC SURGERY, STE 110
Provider Business Practice Location Address City Name:
SAINT LOUIS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63127-1200
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-514-3500
Provider Business Practice Location Address Fax Number:
314-878-7678
Provider Enumeration Date:
12/26/2022